Orofacial Malignancies in Relatively Young Nigerians: the need for further investigations of the molecular landscape.
Main Article Content
Abstract
Background: Occurrence of Orofacial malignancies (OFM) is a major global public health issue, being the sixth most common cancer in the world with 500,000 new incidences per year. Pattern of distribution among the younger age group needs to be explored and compared with the pattern among patients in older age groups.
Materials and methods: Clinical and histologic information on subjects diagnosed as OFM over a 11-year period was retrieved. Data collected and analyzed with SPSS Statistics version 20 was presented as frequency tables, charts and proportions. A confidence interval of 95% was assumed and the level of significance was set at p<0.05.
Results: A total of 286 cases were OFM and 66.1% occurred among subjects within the 4th – 7th decades of life. 40% of cases occurred in subjects aged ≤40 years. There were site and gender predilections for the mandible (25.2%) and male subjects (M: F =1.3:1) respectively. Most common major type was Carcinoma (n=239). Older subjects presented with carcinoma, than with lymphoma (p=0.01).
Squamous Cell Carcinoma [SCC] was the most common type of OFM and Carcinoma, 40.8% of cases occurred in subjects ≤40 years. There was a general pattern of a male gender predilection (M: F =1.6:1) though in subjects ≤40 years, the M: F ratio was reversed (M: F= 1:1.23) when compared with subjects >40 years (M: F= 2.35:1). SCC mostly showed mandible site predilection. However, there was a Maxilla site predilection among young subjects ≤ 40 years and a Mandibular site predilection among subjects > 40 years.
Salivary gland carcinoma accounted for 40.2% of OFM with site and gender predilections for the palate and female respectively. Peak age of occurrence was in the 6th and 7th decades of life and Adenocarcinoma (AC) was the most common observed type.
Sarcoma accounted for 11.8% of OFM and showed a mean age of occurrence of 41 years ±16years, peak age of occurrence in the 5th decade of life and male gender predilection (M:F = 1.2:1) .
Conclusion: There is an increasing number of cases of OFM especially SCC, in Nigerians. It is plausible that unidentified factors may trigger genetic mutations that predispose to OFM development in this environment hence an urgent need for exploration of molecular landscape that may lead to the development of new molecular markers for qualitative management.
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References
1. Ibikunle AA, Taiwo AO, Braimah RO. Oral and maxillofacial malignancies: An analysis of 77 cases seen at an academic medical hospital. J Orofac Sci .2016:80-5
2. Bassey G, Osunde O, Anyanechi C. Maxillofacial tumors and tumor-like lesions in a Nigerian teaching hospital: an eleven year retrospective analysis. African Health Sciences. 2014;14(1):56-63. doi:10.4314/ahs.v14i1.9.
3. Hertrampf K, Wenz HJ, Lehmann KM, Lorenz W, Koller M. Quality of life of patients with maxillofacial defects after treatment for malignancy. Int J Prosthodont 2004;17:657-65.
4. Adisa AO, Adeyemi BF, Oluwasola AO, Kolude B, Akang EE, Lawoyin JO. Clinico-pathological profile of head and neck malignancies at University College Hospital, Ibadan, Nigeria.Head & Face Medicine. 2011;7:9. doi:10.1186/1746-160X-7-9.
5. Elin Ringström, Edward Peters, Masayuki Hasegawa, Marshall Posner, Mei Liuand, Karl T.Kelsey. Human Papillomavirus Type 16 and Squamous Cell Carcinoma of the Head and Neck. Clin Cancer ResOctober 1 2002(8)(10)3187-3192
6. David Goldberg, Juna Lee, Wayne Koch, Micheal Kim, Barry Trink, David Sidransky, Chul-So Moon.Habitual risk factors for head and neck carcinoma. Otolaryngology–Head and Neck Surgery. Vol 131, Issue 6, pp. 986 – 993. First published date: May-17-2016
7. Andisheh Tadbir, Azadeh DMD, MSc; Mehrabani, Davood PhD; Heydari, Seyed Taghi PhD Journal of Craniofacial Surgery: November 2008 - Volume 19 - Issue 6 - pp 1538-1541 doi: 10.1097/SCS.0b013e31818eeccb
8. Lawal AO, Kolude B, Adeyemi BF. Oral cancer: The Nigerian experience. International J Medicine and Medical Sciences 2013; 5(4): 178-83.
9. Web content: Cancer Research UK, http://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence, Accessed [April] [2017].
10. Larizadeh MH, Damghani MA, Shabani M.Epidemiological Characteristics of Head and Neck Cancers in Southeast of Iran.Iran J Cancer Prev. 2014; 7(2):80-6.
11. Lawoyin JO, Lawoyin DO, Fasola AO, Kolude B. Intra-oral squamous cell carcinoma in Nigerians under 40 years of age: a clinicopathological review of eight cases. Afr J Med Med Sci. 2005 Mar;34(1):99-102. PubMed PMID: 15971563.
12. Liu X, Gao X, Liang X, Tang Y. The etiologic spectrum of head and neck squamous cell carcinoma in young patients. Oncotarget. 2016;7(40):66226-66238. doi:10.18632/oncotarget.11265.
13. Chaturvedi AK, Engels EA, Anderson WF, Gillison ML. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol. 2008;26:612–619.
14. Schantz SP, Yu GP. Head and neck cancer incidence trends in young Americans, 1973-1997, with a special analysis for tongue cancer. Arch Otolaryngol Head Neck Surg. 2002;128:268–274.
15. Ajayi OF, Adeyemo WL, Ladeinde AL, Ogunlewe MO, Omitola OG, Effiom OA, Arotiba GT. Malignant orofacial neoplasms in children and adolescents: A clinicopathologic review of cases in a Nigerian tertiary hospital International Journal of Pediatric Otorhinolaryngology , Volume 71 , Issue 6 , 959 – 963.
16. Arotiba GT. A study of orofacial tumors in Nigerian children. J Oral Maxillofac Surg. 1996 Jan;54(1):34-8; discussion 39. PubMed PMID: 8530997.
17. G.T. Arotiba, A.L. Ladeinde, J.O. Oyeneyin, C.C. Nwawolo, A.A.F. Banjo, O.F. Ajayi. Malignant Orofacial neoplasm in Lagos, Nigeria. East African Medical Journal. Vol 83, No. 3, March 2006.
18. da Lilly-Tariah OB, Somefun A, Adeyemo WL. Current evidence on the burden of head and neck cancers in Nigeria. Head & Neck Oncology, 2009, Volume 1, Number 1, Page 14.
19. Hoffman HT, Karnell LH, Funk GF, Robinson RA, Menck HR: The National Cancer Data Base report on cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998, 124 (9): 951-962.
20. Akinbami BO, Omitola OG and Akadiri OA. Pattern of presentation and management of orofacial and neck soft tissue tumors in a Nigerian tertiary health center – a preliminary study. Intern Med Inside. 2013; 1:9. http://dx.doi.org/10.7243/2052-6954-1-9
21. Abuidris DO, Elhaj AH, Eltayeb EA, Elgayli EM, Mustafa OM: Pattern of head and neck malignancies in Central Sudan- (study of 314 cases). Sudan J Med Sci. 2008, 3 (2): 105-108.
22. Anyu W, Xuedong Z, Long C: Analysis of 26,826 patients with tumours in the head and neck. Chinese J Cancer Res. 1993, 5 (2): 153-156. 10.1007/BF02997609
23. Gbotolorun O, Emeka C, Effiom O, Adewole R, Ayodele A. An audit of malignant oro-facial tumors presenting at a tertiary hospital in Lagos. Annals of Medical and Health Sciences Research. 2016;6(2):133-136. doi:10.4103/2141-9248.181840.
24. CE Faggons, C Mabedi, S Gopal. HNSCC in sub-Saharan Africa. Malawi Medical Journal; 27(3): 79-87 September 2015.
25. Effiom OA, Adeyemo WL, Omitola OG, Ajayi OF, Emmanuel MM, Gbotolorun OM. Oral squamous cell carcinoma: a clinicopathologic review of 233 cases in Lagos, Nigeria. J Oral Maxillofac Surg. 2008 Aug;66(8):1595-9. doi:10.1016/j.joms.2007.12.025. PubMed PMID: 18634945
26. Chen J, Katz RV, Krutchkoff DJ: Intraoral squamous cell carcinoma: Epidemiologic patterns in Connecticut for 1935 to 1985. Cancer 66:1288 - 1296, 1990
27. Chidzonga MM: Oral malignant neoplasia: A survey of 428 cases in two Zimbabwean hospitals. Oral Oncol 42:177, 2006
28. Ojua TA, Ishor DG, Ndom PJ: African cultural practices and health implications for Nigeria rural development. International Review of Management and Business Research. Vol. 2, Issue. 1: 176 – 183, 2013
29. Web content: A primer on Tobacco consumption and regulation in Nigeria, http://cpparesearch.org/a-primer-on-tobacco-consumption-and-regulation-in-nigeria, Accessed [JUNE] [2017].
30. Web content: World Health Organzation. www.who.int/countries/nga/en. Accessed [July][2017]
31. Shiboski CH, Schmidt BL, Jordan RC: Tongue and tonsil carcinoma: Increasing trends in the US population age 20– 44 years. Cancer 103:1843, 2005
32. Web content: Nigeria Tobacco Control Bill, http://www.nigeriatobaccocontrol/2012/04/smoking-growing-pastime-for-nigerian.html, Accessed [JUNE] [2017].
33. Web content: World Health Organization. http://www.who.int/tobacco/publications/gender/en_tfi_gender_women_impact_tobacco_use_women_health.pdf. Accessed [JUNE] [2017].
34. Azimi Somayyeh, Tennant Marc, Kruger Estie, Taheri Jamileh Bigom, Sehatpour Marziye, Rezaei Babak . Orofacial cancers in the West of Iran: A 10-year study. J Orofacial Sciences. Year : 2016 | Volume: 8 | Issue Number: 2 | Page: 123-127.
35. J.M. Loyzaga, P. Fernandez Machin, J. Sala, Osteogenic Sarcoma of the Tongue, Pathology - Research and Practice, Volume 192, Issue 1, 1996, Pages 75-78, ISSN 0344-0338. http://dx.doi.org/10.1016/S0344-0338(96)80137-3.
36. Odukoya O, Mosadomi A, Sawyer D: Squamous cell carcinoma of the oral cavity. A clinicopathological study of 106 Nigerian cases. J Maxillofac Surg. 1986, 14: 267-269
37. Daramola JO, Ajagbe HA, Oluwasanmi JO: Pattern of oral cancer in a Nigerian population. Br J Oral Surg. 1979, 17 (2): 123-128. 10.1016/S0007-117X(79)80039-6.
38. Johnson NW: Orofacial neoplasms: Global epidemiology, risk factors and recommendations for research. Int Dent J. 1991, 41 (6): 365-375.
39. Lilly-Tariah da OB: Cancer of the nose and paranasal sinuses in jos: a 10 year study. West Afr J ORL-HNS. 1999, 2: 11 – 16.
40. Ojesina AI, Akang EEU, Ojemakinde KO: Decline in the frequency of Burkitt's lymphoma relative to other childhood malignancies in Ibadan, Nigeria. Ann Trop Pediatr. 2002, 22 (2): 159-163. 10.1179/027249302125000887.